No abstract available.
Dysentery, Amebic ; Enterocolitis, Pseudomembranous ; Sigmoidoscopy

Sigmoidscopy is thought to be one of the basest and most essential tools for evaluation of colorectal patient because it could be performed in an out patient clinic with only minimal bowel preparation. AIM: The aim of this study was to assess the patient's best position for sigmoidoscopy. MATERIALS AND METHODS: Between March 4, 1997 and April 18, 1997, all patients who visited the colorectal clinic at the Dept. of Surgery, Korea Veterans Hospital were alternately underwent sigmoidoscopy in these four different positions: supine(S), left lateral(L), right lateral(R), and jack-knife(J). Sigmoidocopy was routinely performed for all patients who had lower gastrointestinal problems and was done by two well traind surgeons who had performed more than 100 sigmoidoscopies previously to this study, The patients who could not be tolerate insertion of the total length (60 cm) of the sigmoidoscope due to poor bowel preparation and/or complete obstruction by a mass were excluded. We evaluated the patient's complaints according to minimal, moderate, and severe discomfort and time between start and complete insertion of the 60 cm length of the sigmoidoscope. Statistical analysis was performed by an appropriate Anova test and Fisher's exact test. RESULTS: There were no differences among these four groups relative to age(5; 58.0+/-12.7, L; 64.3+/-10.0, R; 62.0+/-10.1, J; 56.0+/-12.9), gender(5; 76%, L; 70%, R; 72%, J, 83%,male ratio), degree of discomfort (mild: 42.9% (5), 50% (L), 33.3%(R), 66.7%(J), moderate: 42.9%(5), 34.6%(L),25%(R), 13.3%(J), severe: 14.3%(5), 15.4%(L), 41.7%(R), 20%(J)) and duration of insertion of the sigmoidoscope(5; 264.4 +/-192.9, L; 226.5 +/-267, R; 301.6+/-361.3, J; 202.5 +/-117.8 seconds). Also, there were no statistical significances between the two groups according to the surgeon who performed the procedure. CONCLUSION: The best position for sigmoidoscopy does not depend on the patient's position. Therefore, allowing the patient to change his position during the procedure would be the best way for an easy and comfortable sigmoidscopy.
Hospitals, Veterans ; Humans ; Korea ; Sigmoidoscopes ; Sigmoidoscopy*

Although malignant melanoma usually occurs after the diagnosis of vitiligo-like depigmentation, the latter is rarely followed by the former. We herein report on such a case in which recognition of the vitiligo-like depigmentation preceded diagnosing the metastatic melanoma by several months. A 56-year-old woman had first developed vitiligo-like depigmentation on the forehead, eyelids, neck and back 18 months previously and thereafter she detected a hard mass in the left axilla 2 months previously. Based on the histologic findings, the axillary mass was diagnosed as metastatic melanoma. To evaluate the primary tumor focus, thorough examinations that included PET-CT, bone scan and sigmoidoscopy were performed, but we couldn`t find any the original primary tumor. Our case suggests that the vitiligo-like depigmentation could be a sign that heralds metastatic melanoma.
Axilla ; Eyelids ; Female ; Forehead ; Humans ; Melanoma ; Middle Aged ; Neck ; Sigmoidoscopy

Endoscopic band ligation has been a standard therapy in esophageal varix bleeding since it was first introduced in 1980s. However, technical problems have interrupted as a therapeutic management of lower gastrointestinal bleeding. We report a case of successful management of rectal bleeding with endoscopic band ligation in patient with chronic renal failure, who had been managed by hemodialysis since eight months before. Successful control of rectal bleeding was achieved by endoscopic band ligation. Three days later, round and shallow ulcer developed at the ligated site, which was improved at follow-up sigmoidoscopy and bleeding was not observed any more. He was discharged without complications. Herein, we report the band ligation as a useful method in treatment of rectal bleeding.
Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Humans ; Kidney Failure, Chronic ; Ligation* ; Renal Dialysis ; Sigmoidoscopy ; Ulcer

Leiomyoma of the rectum is a rare tumor and it usually present in 40 to 60 year-old individuals, and it is more frequent in men. It originates from either the muscularis mucosa or muscularis externa and those arising from the muscularis mucosa are typically small and they are identified incidentally in patients who are undergoing sigmoidoscopy. In contrast, the larger leiomyomas arising from the muscularis externa generally present symptoms that are consistent with rectal stenosis or a rectal mass. Endoscopic ultrasonography can help to define the tumor location, extension and size. Surgical resection is the treatment for most leiomyomas of the rectum, but endoscopic electroexcision is a safe and appropriate treatment for small polypoid rectal leiomyoma. We report here on a case of a semipedunculated rectal leiomyoma in a 59 year-old female patient. It was found incidentally during a colonoscopic examination and it was diagnosed by endoscopic ultrasonography. We performed endoscopic mucosal resection with colonoscopic snare electrocoagulation.
Constriction, Pathologic ; Electrocoagulation ; Endosonography ; Female ; Humans ; Leiomyoma ; Male ; Mucous Membrane ; Rectum ; Sigmoidoscopy ; SNARE Proteins

A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone.
Anesthesia, Spinal ; Biopsy ; Female ; Granulation Tissue ; Hemorrhage* ; Hemorrhoidectomy ; Hemorrhoids ; Humans ; Sigmoidoscopy

Colorectal injury related to anorectal manometry is very rare and is mostly associated with previous rectal surgery. We experienced two cases of colorectal injury related to anorectal manometry in patients without a history of surgery. The anorectal manometry finding of the first patient suggested rectal hyposensitivity, and the maximum tolerable volume was measured as 350 mL. After anorectal manometry, she complained of hematochezia. Sigmoidoscopy showed a deep 5 cm ulcer with vessel exposure at the rectum. She recovered after conservative treatment. In the second case, rectal bleeding occurred while measuring the maximal tolerable rectal volume. A 2.5 cm mural defect and 4 cm mucosal defect were detected in the rectosigmoid area at sigmoidoscopy. Computed tomography showed intraperitoneal free air around the distal sigmoid colon. She improved after conservative management. We suggest that anorectal manometry be performed with great caution, even in patients without a history of surgery.
Colon, Sigmoid ; Gastrointestinal Hemorrhage ; Glycosaminoglycans ; Hemorrhage ; Humans ; Intestinal Perforation ; Manometry ; Rectum ; Sigmoidoscopy ; Ulcer

Actinomycosis is an indolent, slowly progressive infection caused by actinomyces species that normally colonize the mouth, colon, and vagina, characterized by sulfur granule formation. Actinomycosis can affect multiple organs, with local or systemic manifestations. The abdomen is involved in less than 20% of the cases with the ileocecal area being the site most frequently affected. The anorectal region is less frequently involved. We report a case of anorectal actinomycosis, which was diagnosed by histologic study of sigmoidoscopic biopsy. The patient was a 40-year-old man who took immunosuppressive agents after kidney transplantation. Adequate surgical excision was done, being followed by administration of massive dose of a penicillin.
Abdomen ; Actinomyces ; Actinomycosis* ; Adult ; Biopsy ; Colon ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; Mouth ; Penicillins ; Sigmoidoscopy ; Sulfur ; Vagina

BACKGROUND/AIMS: The aim of this study was to examine the incidence of proximal colon adenoma according to characteristics of distal colon adenoma. METHODS: Ninety-two colon adenoma patients who underwent total colonoscopy and endoscopic polypectomy were analyzed retrospectively. Adenoma was classified as proximal when located in proximal to splenic flexure. The advanced adenoma was defined as an adenoma larger than 10 mm or any size with a villous component or severe dysplasia. RESULTS: The incidence of proximal adenoma was increased significantly in those with old age (odds ratio (OR)=3.3), villous (OR=5.3) or dysplastic histology (OR=8.1) or the presence of advanced distal adenoma (OR=3.4). However, the incidence of advanced proximal adenoma was increased only in those with old age (OR=11.2). Nineteen in thirty-nine (48.7%) patients with proximal colon adenoma did not have distal colon adenoma. CONCLUSIONS: Various characteristics of distal colon adenoma couldn't exactly predict the presence of synchronous proximal adenoma and a greater percentage of subjects with proximal adenoma didn't have distal adenoma. So, colonoscopy could be a standard method for colon cancer screening in Korea.
Adenoma* ; Colon* ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopy ; Humans ; Incidence* ; Korea ; Mass Screening ; Retrospective Studies ; Sigmoidoscopy

Trichuriasis is an intestinal infection of human beings caused by Trichuris trichiura, more commonly known as whipworm because of its whip-like appearance. It is characterized by the invasion of the colonic mucosa by the adult trichuris. It is prevalent throughout the world, especially in tropical areas. Diagnosis is made typically by the identification of characteristic barrel-shaped eggs in the feces, although adult worms may be seen rarely at sigmoidoscopy or colonoscopy. We report five cases of whipworm infection that was diagnosed on colonoscopic examination.
Adult ; Colon ; Colonoscopy ; Diagnosis* ; Eggs ; Feces ; Humans ; Mucous Membrane ; Ovum ; Sigmoidoscopy ; Trichuriasis ; Trichuris